You Diagnosed Correctly, But the Claim Still Came
You're an optometrist. You see a patient, run the tests, write the prescription. Everything looks normal. Two weeks later, a lawyer's letter arrives: the patient claims you missed early-stage glaucoma. You recheck your notes—you documented everything. But the patient says they're now losing peripheral vision, and it's your fault.
That scenario isn't hypothetical. According to a real case reported by Berxi, an optometrist faced a claim after a routine eye exam—not for a missed diagnosis, but for an alleged injury from the chin rest. The patient claimed the chin rest knocked out a tooth. The optometrist remembered no such incident, and the claim ultimately didn't hold up. But the stress, the time, the fear—that was real.
Diagnostic errors are one of the most common reasons optometrists get sued. Missed glaucoma, delayed retinal detachment diagnosis, failure to spot a brain tumor during a routine exam—these cases happen more often than you'd think. And the fallout isn't just emotional. The National Practitioner Data Bank reports that 26% of all medical malpractice payments from 2012 to 2022 involved non-physicians—including optometrists.
So, what happens when a claim comes? And is your employer's policy enough?
What a Missed Diagnosis Looks Like in Real Life
Let's walk through a typical scenario, based on anonymized claims data.
A 55-year-old patient comes in for a comprehensive exam. You check intraocular pressure, examine the optic nerve, run a visual field test. Everything is within normal limits. You prescribe reading glasses and send them on their way.
Eight months later, the patient goes to another optometrist complaining of blurry vision. That doctor diagnoses advanced glaucoma with significant field loss. The patient sues you, claiming you should have caught it earlier. Their attorney argues that standard of care required additional testing—maybe an OCT scan—or a shorter follow-up interval given the patient's age and family history.
Your defense: You followed standard protocols. The optic nerve looked healthy. Pressures were normal. But now you're spending hours gathering records, talking to your insurer, and worrying about your reputation. Even if you win, the process is brutal.
That's exactly what the Berxi optometrist experienced. Her claim was eventually dismissed, but she told the claims team that the anxiety affected her work and sleep for weeks. As Berxi's claims examiner Ed noted, “Even when a claim seems baseless, the emotional impact is very real.”
Does Your Employer's Policy Cover Diagnostic Errors?
Maybe. But probably not in the way you need.
Most employer-provided malpractice insurance is claims-made. That means it only covers claims filed while the policy is active. If you leave that job—or if your employer changes carriers—you lose coverage for past incidents unless you buy tail coverage (extended reporting endorsement), which can cost 1.5 to 2 times your annual premium.
Even more important: Employer policies are designed to protect the facility first. They often:
- Exclude license defense—so if the state board investigates, you pay your own lawyer.
- Allow the insurer to settle without your consent—even if you did nothing wrong.
- End the moment you change jobs—leaving you exposed for claims from prior work.
Diagnostic errors, by nature, often take months or years to surface. A glaucoma missed today might be discovered two years from now—when you're working at a different practice. Without your own policy, you'd be uninsured for that claim.
What Your Own Policy Should Include
If you're an optometrist—whether you own a practice or work as an employee—you need individual coverage that addresses diagnostic exposure. Here's what to look for:
- Occurrence form (preferred) – covers any incident that happened while the policy was active, no matter when the claim is filed. No tail needed. Carriers like CPH & Associates and HPSO offer occurrence policies.
- License defense coverage – pays for legal fees if the state board investigates you. HPSO includes up to $25,000 in license defense. Berxi covers defense costs outside the policy limit.
- Consent to settle – you get to decide whether to settle a claim, not the insurer.
- Portability – the policy stays with you between jobs.
If you choose a claims-made policy (like some from Proliability or CM&F Group), make sure tail coverage is available and budget for it.
How Much Does Optometrist Malpractice Insurance Cost?
Premiums vary by state, claims history, and coverage limits. For optometrists, annual premiums typically range from about $500 to $1,500 for $1 million per occurrence / $3 million aggregate. A policy with higher limits or occurrence form will be at the upper end. Final pricing comes from the carrier at quote, so always get multiple quotes.
To compare carriers, visit our carrier comparison hub.
The Lesson from That Chin Rest Claim
The Berxi optometrist's claim was unusual—a patient alleging a dental injury from equipment. But the lesson applies to any diagnostic claim: you can do everything right and still get sued. What saved her was having a responsive claims team and a policy that covered the defense, even for a seemingly frivolous allegation.
If you're an optometrist working for someone else, don't assume you're covered. Ask your employer for a copy of the policy. Check if it includes license defense, tail coverage, and your name as an additional insured. If it doesn't, buy your own. It's not about distrusting your employer—it's about protecting your career.
For profession-specific guidance, see our guides for nurse practitioners, registered nurses, therapists, psychologists, social workers, physical therapists, occupational therapists, dental hygienists, pharmacists, massage therapists, and notaries.
Caveat: This article is based on general industry data and real claim examples. Your specific risk and premium depend on your state, practice setting, and claims history. Always consult a licensed insurance agent for personalized advice.